scholarly journals Assessment of pregnancy outcome with low molecular weight heparin therapy: a retrospective, single centre observational study

2018 ◽  
Vol 7 (4) ◽  
pp. 1446
Author(s):  
Ankita Singh ◽  
Madhuri Alwani ◽  
Nutan Yadav ◽  
Priyam Padia
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Pregnant Women ◽  
Pregnancy Outcome ◽  
Low Molecular Weight Heparin ◽  
Anticoagulation Therapy ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Background: The objective of this study was to determine the outcomes of Low Molecular Weight Heparin Therapy (LMWH) given for various indications during pregnancy.Methods: In this context, a detailed retrospective analysis of all the patients who received LMWH for various indications over a period of two years from October 2015 to November 2017 at a single center, Sri Aurobindo Medical College and PG institute in Indore was performed.Results: Total 100 patients were studied, included over the period of 2 years for various indications for which Enoxaparin (1 mg/kg body weight OD/BD subcutaneously) was used. The indications were valvular heart disease with valve replacement and atrial fibrillation (54.0%), chronic deep vein thrombosis (DVT) (13.0%), thrombophilias (9.0%), recurrent pregnancy loses (21.0%) and prophylaxis for deep vein thrombosis (3.0%) in overall patients. Abortion was seen in 8.0 % patients; fetal growth restriction in 13% patients; and oligohydramnios, preeclampsia, gestational hypertension, placenta previa, abruptio placentae, postpartum hemorrhage patients and Stillbirth occurred in 4.0 % patients. No thromboembolic event was noted in any of the patients. None of the patients had any documented thrombocytopenia or clinical fracture.Conclusions: Low Molecular Weight Heparin Therapy (LMWH) used amongst pregnant women with various indications for anticoagulation therapy was associated with successful pregnancy outcome in the vast majority of cases. Further multicenter prospective studies and international registries of pregnant women on LMWH are necessary to broaden our knowledge in optimizing the care of women who require anticoagulation during pregnancy.

Adjusted Versus Fixed Doses of the Low-Molecular-Weight Heparin Fragmin in the Treatment of Deep Vein Thrombosis

1994 ◽  
Vol 71 (05) ◽  
pp. 698-702 ◽  
Author(s):  
M Alhenc-Gelas ◽  
C Jestin-Le Guernic ◽  
J F Vitoux ◽  
A Kher ◽  
M Aiach ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Factor Xa ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Group A ◽  
Group B ◽  
Deep Vein

SummaryTreatment monitoring based on a laboratory parameter increases the efficacy and safety of standard heparin therapy, but it is not known if this also applies to low-molecular-weight heparin (LMWH) therapy of acute deep vein thrombosis (DVT). In a prospective randomized trial involving 122 consecutive patients, group A (58 patients) received a weight adjusted dose of Fragmin (100 IU/kg) subcutaneously twice a day throughout the treatment period (10 days ± 1), while in group B (64 patients) the dosage was based on the results of an anti factor Xa (anti Xa) amidolytic assay to obtain a target concentration from 0.5 to 1 IU/ml. AntiXa and antithrombin activities were also measured retrospectively on frozen plasma from all patients. The two regimens were comparable in terms of hemorrhagic complications (4 in group A and 3 in group B). Bilateral ascending phlebography was performed before inclusion and at the end of LMWH treatment. Treatment efficacy, based on Marder’s score, did not differ between the two groups (p = 0.3). Dosage adjustment to between 0.5 to 1IU anti-Xa/ml does not therefore appear to improve the efficacy or safety of LMWH tieatment. However, correlations between the change in Marder’s score and both anti-Xa (p <0.001) and antithrombin activity (p <0.001) were observed, suggesting a relationship between the degree of FXa or thrombin inhibition and antithrombotic activity.

scholarly journals Deep vein thrombosis and our treatment applications: 12-year results

2021 ◽  
Vol 2 (4) ◽  
Author(s):  
Borulu F ◽  
◽  
Erkut B ◽  
Keyword(s):  
Quality Of Life ◽  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Mechanical Thrombectomy ◽  
Heparin Therapy ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

Introduction: Deep vein thrombosis is an important health problem that is frequently encountered in the general population and especially in surgical clinics and has a negative impact on quality of life. In this study, treatment options and results of patients with deep vein thrombosis who have been hospitalized for 12 years in Atatürk University and Erzurum Regional Hospital were examined and discussed. Methods: In our clinic, 412 cases of deep vein thrombosis (211 female, 201 male) were hospitalized between 2009 and 2021. The mean age of the patients was 49 ± 19 years. While medical treatment with heparin was given to all 412 patients; thrombolytic therapy, surgical embolectomy (vascular and pulmoner), and pharmaco-mechanical thrombectomy were applied to some of these patients. Results: Deep vein thrombosis was more common in the lower extremity (n=322, 78.2%). All patients had at least one of the complaints of pain, swelling and redness. All cases were diagnosed by color Doppler ultrasonography. Medically, standard and low molecular weight heparin therapy was given to all patients after hospitalization. Thrombolytic therapy was applied to 66 (16,1%) of the cases, pulmonary embolectomy to 8 (1,9%), surgical thrombectomy to 10 (2,4%) and pharmacomechanical thrombectomy to 44 (10,7%) patients. In addition to these 120 patients (29.1%), a vena cava filter was placed for prophylactic purposes. Conclusions: In patients diagnosed with deep vein thrombosis and hospitalized, the diagnosis should be supported by Doppler ultrasound in addition to clinical diagnosis after an etiology investigation. Early diagnosis, rapid and effective treatment methods are important for the subsequent quality of life of patients. In addition to low molecular weight heparins being the first choice agents, standard heparin administration still needs to be applied in some clinical pictures. In addition, we believe that pharmacomechanical thrombectomy can be applied in appropriate acute cases. Keywords: Deep vein thrombosis; anticoagulant treatment; heparin therapy; low-molecular-weight heparin; mechanical thrombectomy.

Comparison of a once Daily with a twice Daily Subcutaneous Low Molecular Weight Heparin Regimen in the Treatment of Deep Vein Thrombosis

1998 ◽  
Vol 79 (05) ◽  
pp. 897-901 ◽  
Author(s):  
Bernard A. Charbonnier ◽  
Jean-Noël Fiessinger ◽  
J. D. Banga ◽  
Ernst Wenzel ◽  
Pascal d’Azemar ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Daily Regimen ◽  
Once Daily ◽  
Daily Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryBackground: Clinical trials have been performed to compare with standard heparin a once or a twice daily regimen of low-molecular-weight heparin but no direct comparison has been done between these two low-molecular-weight heparin regimens in terms of efficacy and safety with a long-term clinical evaluation.Methods: Patients with proximal deep vein thrombosis, confirmed by venography were randomly assigned to either nadroparin (10,250 AXa IU/ml) twice daily or nadroparin (20,500 AXa IU/ml) once daily for at least 5 days. Regimens were adjusted to bodyweight. Oral anticoagulants were started on day 1 or 2 and continued for 3 months. Patients were followed up for 3 months. The composite outcome of venous thromboembolism and death possibly related to pulmonary embolism was the primary measure of efficacy. Major bleeding was the principal measure of safety. The study was designed to show equivalence between the two regimens.Results: Recurrent thromboembolic events or death possibly related to pulmonary embolism were reported in 13 patients in the once daily group (4.1%) and in 24 patients of the twice daily group (7.2%): (absolute difference 3.1% in favor of the once daily regimen; 95% confidence interval -6.6%, +0.5%). Major bleeding episodes during nadroparin treatment occurred in 4 (1.3%) and 4 patients (1.2%) in the once and twice daily groups, respectively.Conclusions: A nadroparin regimen of one injection per day is at least as effective and safe as the same total daily dose divided over two injections for the treatment of acute deep vein thrombosis.

scholarly journals Combination of Traditional Chinese Medicine and Low-Molecular-Weight Heparin Prevents Deep Vein Thrombosis After Surgery: A Meta-Analysis

2019 ◽  
Vol 25 ◽  
pp. 107602961989041
Author(s):  
Chu Chen ◽  
Qing Tang ◽  
Wenjuan Zhang ◽  
Huijun Yuan ◽  
Ying Huai ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Low Molecular Weight Heparin ◽  
Mean Difference ◽  
Combination Group ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Deep Vein

At present, there is no consistent understanding of the effect of traditional Chinese medicine (TCM) prescription in the prevention of the deep vein thrombosis (DVT), though TCM has been widely used in China. To evaluate the efficacy of TCM prescription combined with low-molecular-weight heparin (LMWH) for preventing DVT after major orthopedics surgery. All the retrieved articles were evaluated using specific inclusion and exclusion criteria. Then, data were extracted and evaluated for inclusion in a randomized controlled trial. In this study, variables included relative risk (RR), mean difference (MD), and their corresponding 95% confidence intervals (95% CIs). Overall, 16 articles were included with 1538 patients, 768 in the combination group (combination of TCM prescription and LMWH) and 770 in the LMWH group. The results indicated that in the combination group, the incidence of DVT (RR: 0.34, 95% CI: 0.23-0.50, P < .00001) and d-dimer levels (standardized mean difference: −1.19, 95% CI: −1.80 to −0.58, P = .0001) was significantly lower than that in the LMWH group. Furthermore, the combination treatment obviously decreased the concentration of fibrinogen (MD: −1.19, 95% CI: −2.13 to −0.25, P = .01). The combination of TCM prescription and LMWH could significantly reduce the incidence of DVT, suggesting that it may be a more effective prophylaxis measure for DVT after major orthopedics surgery.

scholarly journals Low-molecular-weight heparin and prevention of postoperative deep vein thrombosis.

BMJ ◽  
1982 ◽  
Vol 284 (6313) ◽  
pp. 375-379 ◽  
Author(s):  
V V Kakkar ◽  
B Djazaeri ◽  
J Fok ◽  
M Fletcher ◽  
M F Scully ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Deep Vein Thrombosis ◽  
Low Molecular Weight Heparin ◽  
Low Molecular Weight ◽  
Vein Thrombosis ◽  
Postoperative Deep Vein Thrombosis ◽  
Deep Vein
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